Renal denervation for treatment of ventricular arrhythmias: data from an International Multicenter Registry
Date
2016
Authors
Ukena, C.
Mahfoud, F.
Ewen, S.
Bollmann, A.
Hindricks, G.
Hoffmann, B.A.
Linz, D.
Musat, D.
Pavlicek, V.
Scholz, E.
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Journal article
Citation
Clinical Research in Cardiology, 2016; 105(10):873-879
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Christian Ukena, Felix Mahfoud, Sebastian Ewen, Andreas Bollmann, Gerhard Hindricks, Boris A. Hoffmann, Dominik Linz, Dan Musat, Valerie Pavlicek, Eberhard Scholz, Dierk Thomas, Stephan Willems, Michael Böhm, Jonathan S. Steinberg
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Abstract
Introduction: Ventricular arrhythmias (VAs) in patients with chronic heart failure (CHF) are sometimes refractory to antiarrhythmic drugs and cardiac ablation. This study aimed to investigate catheter-based renal sympathetic denervation (RDN) as antiarrhythmic strategy in refractory VA. Methods: These are the first data from a pooled analysis of 13 cases from five large international centers (age 59.2 ± 14.4 years, all male) with CHF (ejection fraction 25.8 ± 10.1 %, NYHA class 2.6 ± 1) presented with refractory VA who underwent RDN. Ventricular arrhythmias, ICD therapies, clinical status, and blood pressure (BP) were evaluated before and 1–12 months after RDN. Results: Within 4 weeks prior RDN, a median of 21 (interquartile range 10–30) ventricular tachycardia (VT) or fibrillation (VF) episodes occurred despite antiarrhythmic drugs and prior cardiac ablation. RDN was performed bilaterally with a total number of 12.5 ± 3.5 ablations and without peri-procedural complications. One and 3 months after RDN, VT/VF episodes were reduced to 2 (0–7) (p = 0.004) and 0 (p = 0.006), respectively. Four (31 %) and 11 (85 %) patients of these 13 patients were free from VA at 1 and 3 months. Although BP was low at baseline (116 ± 18/73 ± 13 mmHg), no significant changes of BP or NYHA class were observed after RDN. During follow-up, three patients died from non-rhythm-related causes. Conclusions: In patients with CHF and refractory VA, RDN appears to be safe concerning peri-procedural complications and blood pressure changes, and is associated with a reduced arrhythmic burden.
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© Springer-Verlag Berlin Heidelberg 2016